Send to

Choose Destination
Br J Dermatol. 2019 Jun 30. doi: 10.1111/bjd.18265. [Epub ahead of print]

Topical treatments in atopic dermatitis: unexpectedly low use of emollients; use of topical corticosteroid is higher in juvenile patients, higher in male vs females, and shows independent associations with asthma and depression.

Author information

School of Medicine, University of Dundee, Medical School, Dundee, Scotland.



Despite decades of use,the actual amounts of topical corticosteroids (TCS) and emollients used in moderate-to-severe atopic dermatitis (AD) under real-world conditions are unknown. Thus, it remains unclear if inadequate use is widespread.


To quantify the use of TCS and emollients in moderate-to-severe AD.


Double-blinded drug prescribing recorded prospectively at the point of drug dispensing within a catchment of approx. 450,000 over a 31-year period in a population-based cohort marked by failure of disease control in primary care (n = 844). For each patient, prescribing was recorded over 12-month to minimize fluctuations.


The resulting dataset was near-complete, and essentially free of reporting- and recording bias. Atopic co-morbidities matched expected frequencies. Median use of TCS was statistically significantly higher in juvenile (age < 16) compared to adult patients (49·2 vs. 38·1 gram / month), in males vs. females (46·8 vs. 29·7), and in patients receiving concurrent asthma treatment (40·4 vs. 26·7). TCS use was strongly associated with anti-depressant treatment. Emollient use was unexpectedly low at median of 9·6 gram/day (range 1·4 - 30·1). Results replicated in an independent validation cohort. Conclusions Deficient use of emollients may be a factor contributing to AD severity. TCS use does not exceed current guidelines. Accurate quantification of topical treatments provides a widely accessible strategy to measure real-world impact of novel AD treatments. This article is protected by copyright. All rights reserved.


atopic dermatitis; comorbidity; corticosteroid; database


Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center